Shock wave generators are used in numerous medical fields. The most commonly known field is the therapeutic and cosmetic application in the treatment, for example, of calculous diseases (e.g. urolithiasis, cholelithiasis) and the treatment of scars in human and veterinary medicine.
New fields of application involve dental treatment, the treatment of arthrosis, the removal of calcerous deposits (e.g. tendinosis calcarea), the treatment of chronic tennis or golfer elbows (so called radial or ulnar epicondylopathy), of chronic discomfort of the shoulder tendons (so called enthesopathy of the rotator cuff), and of chronic irritation of the Achilles tendon (so called achillodynia).
Furthermore, the generation of shock waves is also used in the therapy of osteoporosis, periodontosis, non-healing bone fractures (so called pseudoarthrosis), bone necrosis, and similar diseases. More recent research studies also investigate the application in stem cell therapy.
Furthermore, the shock wave generation can also be used to exert mechanical stress, e.g. in the form of shearing forces, on cells, whereby their apoptosis is initiated. This occurs for example by means of an initiation of the ‘death receptor pathway’ and/or the cytochrome c-pathway and/or a caspase cascade.
The term apoptosis is understood to mean the initiation of a genetically controlled program which leads to the ‘cell suicide’ of individual cells in the tissue structure. As a result, the cells concerned and their organoids shrink and disintegrate into fragments, the so-called apoptotic bodies. These are phagocytized afterwards by macrophages and/or adjoining cells. Consequently, the apoptosis is a non-necrotic cell death without inflammatory reactions.
Therefore, the application of shock waves is advantageous in all cases where the treatment of diseases with an abased rate of apoptosis is involved, e.g. the treatment of tumours or viral diseases.
Furthermore, the shock wave generation can be applied advantageously in the treatment of necrotically changed areas and structures in muscle tissue, especially in the tissue of the cardiac muscle, in the stimulation of cartilage assembly in arthritic joint diseases, in the initiation of the differentiation of embryonic or adult stem cells in vivo and in vitro in relation to the surrounding cell structure, in the treatment of tissue weakness, especially of cellulitis, and in the degradation of adipose cells, as well as the activation of growth factors, especially TGF-[beta].
The generation of shock waves can also be used for avoiding the formation and/or expansion of edema, for degradation of edema, for the treatment of ischaemia, rheumatism, illnesses of joints, jaw bone (periodontosis), cardiologic diseases and heart attacks, pareses (paralyses), neuritis, paraplegia, arthrosis, arthritis, for the prevention of scar formation, for the treatment of scar formation and nerve scarring, respectively, for the treatment of achillobursitis and other bone necroses.
A further application relates to the treatment of spinal cord and nerve lesions, for example spinal cord lesions accompanied by the formation of edema.
Shock waves are also applicable for the treatment of scarred tendon and ligament tissue as well as poorly healing open wounds.
Such poorly healing open wounds and boils are called ulcus or also ulceration. They are a destruction of the surface by tissue disintegration at the dermis and/or mucosa. Depending on what tissue fractions are affected, surfacial lesions are called exfoliation (only epidermis affected) or excoriation (epidermis and corium affected).
Open wounds that can be treated with shock waves comprise especially chronic leg ulcers, hypertensive ischaemic ulcers, varicose ulcers or ulcus terebrans due to a subsequently caused improved healing process.
Furthermore, shock waves are suitable for the stimulation of cell proliferation and the differentiation of stem cells.
Typical shock wave generators have a basis device, to which a therapy head can be connected. The therapy head comprises an integrated reflector with a shock wave source and a coupling membrane.
During the use of shock waves for the destruction of concrements, a shock wave energy of approximately 1 to 5 J is normally applied. For this purpose, a capacitor with a capacity of approximately 10 to 100 nF is charged to a voltage of approximately 15 to 30 kV and then unloaded by way of a spark discharge section.
The spark discharge section consists of two electrodes that are essentially pointed and whose tips are arranged at a distance of approx. 1.5 to 3 mm from one another. Normally, the distance is approx. 1 mm per 10 kV charge voltage.
The shock wave generators known up to the present are disadvantageous in that the switches for such high voltages are sophisticated and expensive and are, in addition, often unreliable. It is therefore that task of this invention to provide a shock wave generator which can be operated with less complicated and more reliable switches.
This task is solved by a shock wave generator according to the present invention.